Discrimination as to Maintaining External Causes and Surgical Cases

The physician is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health. The aim should be to discriminate and remove external causes and turn into order internal causes. …

We wish to revert for a short time to the fourth paragraph, in which Hahnemann says:”The physician is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health.”

The Homoeopathic physician is a failure if he does not discriminate. It seems that among the earliest things he must learn is to “Render unto Caesar the things that are. Caesar’s,” to keep everything in its place, to keep everything in order. This little paragraph might seem to relate to nothing but hygiene.

One of the most superficial things in it so say that persons about to be made sick from bad habits should break off their bad habits, they should move from damp houses they should plug their sewers or have traps put in if they are being poisoned with sewer gas. It is everybody’s duty to do these things, but especially the physician’s, and we might almost let it go with the saying. To prevent coffee drinking, vinegar drinking, etc. is a superficial thing; but in this way he may preserve health.

To discriminate, then, is a most important thing. To illustrate it in a general way we might say that one who is suffering from conscience does not need a surgeon. You mighty say he needs a priest. One who is sick in his vital force needs a physician. He who has a lacerated wound, or a broken bone, or deformities, has need of a surgeon. If his tooth must come out he must have a surgeon dentist.

What would be thought of a man who, on being sent for a surgeon to set an injured man’s bones should go for a carpenter to mend the roof of the man’s house? If the man’s house alone needs mending then he needs a carpenter and not a surgeon. The physician must discriminate between the man and his house, and between the repair of man and the repair of his house.

It is folly to give medicine for a lacerated wound, to attempt to close up a deep wound with a dose of remedy. Injuries from knives, hooks, etc., affect the house the man lives in and must be attended to by the surgeon. When the gross exterior conditions which are brought on from exterior causes complicated with the interior man then medicine is required. If the physician acts also as a surgeon he must know when he is to perform his functions as a surgeon, and when he must keep back as a surgeon. He should sew up a wound, but should not burn out an ulcer with Nitrate of Silver.

If he is not able to discriminate, and on every ulcer he plasters his external applications, he is not a preserver of health. When signs and symptoms are present the physician is needed, because these come from the interior to the exterior. But if his condition is brought on only from external causes, the physician must delay action and let the surgeon do his work. Yet we see around us that physicians bombard the house the man lives in and have no idea of treating the man. They are no more than carpenters, they attempt to repair the roof, put on boards and bandages, and yet by their bandaging the man from head to foot they often do an improper thing.

The physician must know the things that derange health and remove them. If a fang of an old tooth causes headache day and night that cause must be removed. To prescribe when a splinter is pressing on a nerve and leave the splinter in would be foolishness and criminal negligence. The aim should be to discriminate and remove external causes and turn into order internal causes.

A man comes for treatment, and he is living on deviled crabs and lobster salad and other trash too rich for the stomach of a dog. If we keep on giving Nux Vomica to that man we are foolish. If a man who has been living viciously stops it he can be helped, but so long as that external cause is not removed the physician is not using discrimination. Vicious habits, bad living, living in damp houses are externals and must be removed. When a man avoids these externals, is cleanly, carefully chooses his food, has a comfortable home, and is still miserable, he must be treated from within.

You know how we are maligned and lied about. You have heard it said about some strict homoeopath, “He tried to set a broken leg with the c.m. potency of Mercury. What a poor fool!” But still outside of such an instance this discrimination is an important matter. You must remember it especially when busy, as at times it will be hard to decide. This kind of diagnosis is important, because it settles between things external and internal. Every physician does not discriminate thus, for if he did there would not be so many poultices and murderous external applications used. Among those who do not discriminate are those who apply medicines externally and give them internally. Now we return to the fifth paragraph, which reads:

Useful to the physician in assisting him to cure are the particulars of the most probable exciting cause of the acute disease, as also the most significant points in the whole history of the chronic disease to enable him to discover its fundamental cause, which is generally due to a chronic miasm. In these investigations the ascertainable physical constitution of the patient (especially when the disease is chronic), his moral and intellectual character, his occupation, mode of living and habits, his social and domestic relations, his age sexual functions, etc., are to be taken into consideration.

Little is known of the real exciting causes. Acute affections are divided into two classes (1) those that are miasmatic, which are true diseases, and (2) those that may be called mimicking sickness. The living in damp houses, grief, bad clothing, etc.; and the causes being latter have no definite cause, are produced by external causes such as removed the patient recovers. But the first, the acute miasms have a distinct course to run. They have a prodromal period, a period of progress and a period of decline, if not so severe as to cause the patient’s death. Measles, scarlet fever, whooping cough, smallpox, etc., are examples of acute miasms.

The physician must also be acquainted with the chronic miasms, psora, syphilis and sycosis, which we will study later. These have like the acute, a prodromal period and a period of progress, but unlike the acute they have no period of decline. When the times and circumstances are favourable the chronic miasm becomes quiescent, but adverse times rouse it into activity, and each time it is aroused the condition is worse than it was at the previous exacerbation.

In this paragraph Hahnemann teaches that the chronic miasms are the fundamental cause of the acute miasms, which is to say, if there were no chronic miasms there would be no acute. It is in the very nature of a chronic miasm to predispose man to acute diseases, and the acute diseases are as fuel added to an unquenchable fire.

Acute diseases then exist from specific causes co-operating with susceptibility. We do not recognize measles or scarlet fever except in sick people. Their influence might exist in the atmosphere, but we can not see it. So apart from the subjects that take and develop them we could not know that there were such diseases. If there were no children on the earth susceptible to measles we would have no measles, and if there were no chronic miasms there would be no susceptibility. We will take up the subject of susceptibility later.

Psora is the cause of all contagion. If man had not had psora he would not have had the other two chronic miasms, but psora, the oldest, became the basis of the others. The physician of the present day do not comprehend Hahnemann’s definition of psora, they think it meant an itch vesicle or some sort of tetter. They regard itch as only the result of the action of a bug that crawls in the skin making vesicles, all of which is external. This is quite in keeping with man’s present form of investigation, because he can comprehend only that which he discovers by his senses.

Hahnemann’s idea of psora, as we shall see when we come to study it, is wholly different from these perverted views. Psora corresponds to that state of man in which he has so disordered his economy to the very uttermost that he has become susceptible to every surrounding influence. The other day I used the illustration of civil government, and said if our civil government is evil in its centre it will be in disorder in its uttermost. So if a man is evil in his very interiors, i.e. in his will and understanding, and the result of this evil flows into his life, he is in a state of disorder. Let man exist for thousands of years thinking false theories and bringing them into his life, and his life will become one of disorder.

Later we will be able to show that this disordered condition of the economy is the underlying and fundamental state of the nature of psora which ultimates upon the body in tissue changes. Suppose a man starts out and believes that it is right for him to live upon a certain kind of food that is very distasteful to him; he lives upon that diet until he thinks (from his belief) that he really loves it, and in time his very outermost becomes as morbid as he is himself.

James Tyler Kent
James Tyler Kent (1849–1916) was an American physician. Prior to his involvement with homeopathy, Kent had practiced conventional medicine in St. Louis, Missouri. He discovered and "converted" to homeopathy as a result of his wife's recovery from a serious ailment using homeopathic methods.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.